Airway Interventions in the Cardiac Electrophysiology Laboratory: A Retrospective Review

Terrence L. Trentman, Sharon L. Fassett, Jeff T. Mueller, Gregory T. Altemose

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Objective: To quantify the incidence of airway interventions during cardiac electrophysiology laboratory procedures. Design: A retrospective chart review. Setting: A tertiary care teaching hospital. Participants: Two-hundred eight adult patients undergoing cardiac electrophysiology laboratory procedures during a 2-year period, March 2006 to March 2008. The patients underwent the following procedures: supraventricular tachycardia ablation, atrial tachycardia ablation, atrial flutter ablation, premature ventricular contraction ablation, and ventricular tachycardia ablation. Patients who were intubated (in the intensive care unit or emergency department) before the ablation began, patients with ventricular assist devices or intra-aortic balloon pumps, and patients receiving inotropic support before the procedure were excluded. Interventions: None. Measurements and Main Results: The data were summarized by using the mean and standard deviation. Of the 208 patients, 186 were planned monitored anesthesia care, and 22 were planned general anesthetics. Of the monitored anesthesia care cases, 20 were converted to general anesthesia, and 54 received some type of airway intervention including oral-pharyngeal airway or nasal airway insertion. Therefore, 40% (74/186) of the non-general anesthesia cases required an airway intervention. Conclusions: These results suggest that a significant proportion of the authors' patients undergoing cardiac electrophysiology laboratory procedures required deep sedation if not general anesthesia, although a non-general anesthetic was planned. The issue of depth of sedation has implications for patient safety, privileging, and regulatory compliance. Based on the present results, the authors believe sedation for these procedures is best given by anesthesia providers; furthermore, caregivers should be aware that these procedures are likely to require deep sedation if not general anesthesia.

Original languageEnglish (US)
Pages (from-to)841-845
Number of pages5
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume23
Issue number6
DOIs
StatePublished - Dec 1 2009

Keywords

  • airway
  • arrhythmia
  • conscious sedation
  • electrophysiologic procedures

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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